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Phlebotomy Handbook Blood Collection Essentials Seventh Edition Diana Garza Kathleen Becan-McBride

Phlebotomy Handbook Blood Collection Essentials Seventh Edition Diana Garza Kathleen Becan-McBride. Chapter Six Safety and First Aid. Goal is to recognize and eliminate hazards and provide information on safety education so employees can have a healthy, safe environment.

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Phlebotomy Handbook Blood Collection Essentials Seventh Edition Diana Garza Kathleen Becan-McBride

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  1. Phlebotomy HandbookBlood Collection EssentialsSeventh EditionDiana GarzaKathleen Becan-McBride Chapter Six Safety and First Aid Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  2. Goal is to recognize and eliminate hazards and provide information on safety education so employees can have a healthy, safe environment. OSHA Act of 1991 mandates the provision of a safe working environment. Safety in specimen handling is critical to avoid acquisition of infection. Safety in Specimen Collection Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  3. Put nothing in your mouth. Wash hands frequently. Never apply cosmetics. No eating or drinking. Tie back long hair. Button lab coat. No food in lab fridge. No loose, dangling clothing or jewelry. Opened toed shoes usually prohibited Personal Hygiene at Work Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  4. Correct handling of specimens Specimens should be covered at all times Centrifuge specimens using appropriate precautions. Dispose of samples in appropriate biohazardous containers. Cover needles by properly utilizing the safety equipment which require a one-handed method of permanently covering the end of the needle. Laboratory Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  5. Safety advisory has been issued for the use of glass capillary tubes to reduce the risk of injury due to breakage and include the following: Avoid using capillary tubes made of glass. Use capillary tubes wrapped in puncture-resistant film. Utilize products which do not require manual filling of end with sealant. Utilize products that allow measurement of hematocrit without centrifugation Laboratory Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  6. Correctly dispose of biohazardous waste. Double bag Causes of infectious airborne transmission Removing rubber stoppers. Splashing during transfer of blood or other body fluids. Centrifuging without covering with biological hood. Not wearing a proper face shield when working with specimens. Exposure to sharps, such as needles and lancets. Laboratory Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  7. Laboratory Safety • Sharps keeper for sharps and broken glass. • Biohazard sharpskeeper for contaminated glass, needles. Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  8. When disposing of specimens in sink, turn water on gently. Urine specimens poured down drain. Blood can be poured down drain if local ordinance permits, most facilities put in biohazard trash. Laboratory Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  9. Laboratory Safety • Special encapsulating powders are available which gel the liquid. Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  10. Use a 1:10 dilution of bleach, must be prepared daily. Blood or body fluid spills must be handled carefully. Place paper towels over spill. Flood with bleach solution Allow to sit for 15-20 minutes before cleaning up. Decontaminate Work Area Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  11. Classification of fires Class A fires Occur with ordinary combustible material, such as wood, rubbish, paper, cloth, and many plastics. Class B fires Occur in a vapor–air mixture over flammable solvents, such as gasoline, oil, paint, lacquers, grease, and flammable gases. Fire Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  12. Laboratory Safety • Colored biohazard labels must be placed on all containers used to store, transport or ship blood or body fluids. Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  13. Phlebotomist responsibilities All employees are responsible for safety. Know the location of fire extinguishers and learn how to use them correctly. Know the procedure for reporting a fire. Know where the fire blanket is. It is mandatory to attend periodic safety programs to review. Fire Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  14. Components of a fire: Fuel Oxygen Heat Necessary chain reaction Fire Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  15. Classification of fires Class A fires Occur with ordinary combustible material, such as wood, rubbish, paper, cloth, and many plastics. Class B fires Occur in a vapor–air mixture over flammable solvents, such as gasoline, oil, paint, lacquers, grease, and flammable gases. Fire Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  16. Classification of fires Class C fires Occur in or near electrical equipment. Class D fires Occur with combustible metals, such as magnesium, sodium, and lithium. Fire Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  17. Fire Safety Courtesy of Health and Environmental Safety, The University of Texas Health Sciences Center at Houston Figure 6.2: Proper Use of the Extinguisher Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  18. Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  19. Fire Extinguishers Type A extinguishers Contain soda and acid or water and are used to cool the ordinary fire such as wood, cloth or paper. Type BC extinguishers Contain foam, dry chemicals, or carbon dioxide (CO2). Are used to combat fires occurring in vapor–air mixtures over solvents such as grease, gasoline or oil fires. Fire Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  20. Fire Extinguishers Type ABC extinguishers Contain a dry chemical and are used on fires of wood, cloth, paper, oil, grease, and gasoline. Multipurpose in combating fires and thus, are located in fire stations throughout health care institutions. Class D fires should be fought by firefighters only. Fire Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  21. Fire Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  22. Rescue/Remove person(s) from the immediate fire scene/room (RESCUE) Immediately pull alarm then call designated number posted on or near phone (ALERT) Close all doors/windows. (CONFINE) If fire is small, use fire extinguisher. (EXTINGUISH) If evacuation is necessary use stairs. If clothing on fire, stop, drop, and roll. If caught in a fire, crawl to exit, get wet towel if possible. Do not block entrance or try to reenter the building. Do not panic or run. Fire Safety - RACE Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  23. Emergency Response to Possible Fire Things to do in a fire response Pull the nearest fire alarm Call 911 or the hospital’s fire emergency number Remove patients from danger Close windows and doors Use an ABC extinguisher for small fire Leave the area immediately by stairs Drop to ground and roll Crawl to the exit Fire Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  24. Major hazard in any area of a health care institution. Potential major hazard is the possibility of electric current passing through a person. Location of circuit breaker boxes. The Healthcare worker should be aware of the location of the circuit breaker boxes in order to assure a fast response in the event of an electrical fire or an electrical shock. Electrical Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  25. Electrical Safety • Power Outage and Emergency Power • In case of power outrage, emergency power is delivered to lights by a red switch toggle. Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  26. Electrical Safety • Preventive maintenance on equipment. • Periodically inspect cords for fraying, if frayed DO NOT use. Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  27. Control switches and thermostats should be in good working order. Unplug equipment when performing preventive maintenance and when cleaning up spills in equipment. Electrical Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  28. Electrical Safety • Procedure to follow when coworker has contact with electrical current. • Unplug equipment first or turn off power. • Do not touch the victim. • To remove electrical contact, use asbestos gloves, which cannot conduct electricity or place hand in glass beaker to push power supply away from the victim Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  29. Electrical Safety • Call for medical assistance and start CPR immediately if needed. • Do not move the victim • Place fire blanket or other warm clothing over victim. Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  30. Using electrical equipment While collecting blood, avoid contact with any electrical equipment Use three-prong “hospital-grade” electrical plugs Actions to take in an electrical accident. Electrical Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  31. Electrical Safety Figure 6.5 Outlet Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  32. The Three Cardinal Principles of Self-protection Time Shielding Distance RadiationSafety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  33. RadiationSafety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  34. RadiationSafety Figure 6.6 Radiation Hazard Sign Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  35. Areas Where Radioactive Materials Are in Use and Stored Nuclear medicine. X-ray department. Radioimmunoassay section in research or a clinical laboratory. Limit time of exposure to patients with radioactive implants. Health care workers who are pregnant should be aware of the potential hazard of radiation to the fetus. RadiationSafety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  36. Radiation Safety • In clinic settings, phlebotomist may be asked to assist with proper placement of patient. • Be knowledgeable about institutions policy pertaining to radiation safety, especially if employee/student is pregnant. Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  37. Centrifuge use and maintenance. MechanicalSafety Figure 6.7 Example of a Centrifuge Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  38. Correct carriers and positions If the carriers are not in the correct position, they can swing out of the holding disks into the side of the centrifuge. Tubes containing patients’ specimens or spinning chemicals may be propelled onto the side of the centrifuge, and broken, and a dangerous, hazardous problem created. MechanicalSafety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  39. Injury in the laboratory can occur due to exposure to poisonous, volatile, caustic or corrosive agents such as strong acids or basis. ChemicalSafety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  40. Different chemicals and reagents can present different types of hazards. Inhalation of fumes can damage lungs (sulfuric acid). Some are corrosive to the skin (phenol). Some are caustic (acetic acid). Some are volatile (some solvents). Some present a combination of hazards. ChemicalSafety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  41. Chemical Safety • All chemical and reagents should be stored in original container, tightly closed and in an appropriate, well ventilated storage area, ie, flammable cabinet Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  42. Hazard communication manual, mandated by OSHA in 1986 and known as the “Right to Know Act” requires that employers maintain documentation related to all hazardous substances and must include the following: Written communication program. Documented training of employees. Sophisticated tracking and documentation of hazardous substances and Material Safety Data Sheets (MSDS). Chemical Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  43. Occupational Safety and Health Administration (OSHA) hazard communication standard (Right to Know) is designed to ensure that lab orders are fully aware of hazards associated with chemicals in the workplace. Chemical Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  44. Each site must have a comprehensive plan to implement the practice of safety measures throughout the lab. Chemical Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  45. Outline the specific work practices and procedures necessary to protect worker from any health hazards associated with hazardous chemicals. Provide information and training regarding hazardous chemicals to all lab worker. Chemical Hygiene Plan Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  46. Chemical Safety • All hazardous chemical labels must contain the following information: • appropriate warning, ie, corrosive • explain nature of hazard, ie, flammable • special precautions to eliminate risks • explain first-aid treatment for exposure Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  47. Information about signs and symptoms associated with exposure to hazardous chemicals used in the lab must be communicates to all. Reference materials for this information are included in the material safety data sheets (MSDS) provided by all chemical manufacturers and suppliers. This information concerns hazards, safe handling, storage, and disposal of hazardous chemicals used in the lab. Chemical Safety Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  48. Information provided by chemical manufacturers about each chemical. Each lab must have on file all MSDSs for the hazardous chemicals used in the lab. Use of MSDS is a common way that potential product hazard information is made available and OSHA requires this provision by all chemical manufacturers. Material Safety Data Sheets (MSDS) Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  49. The health care facility is required to provide this information to its workers. Each MSDS contains basic information about the specific chemical or product including: Trade name, chemical name and synonyms. chemical family Manufacturer’s name, address and phone number for further information. hazardous ingredients. Physical data, fire and explosion data Health hazard and protection information. Material Safety Data Sheets (MSDS) Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

  50. MSDS Sheet Phlebotomy Handbook: Blood Collection Essentials, Seventh Edition Diana Garza • Kathleen Becan-McBride

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